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Precancerous Conditions and Malignant Tumors

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Laser and IPL Technology in Dermatology and Aesthetic Medicine

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Abstract

Lasers can often be used successfully to treat flat precancerous lesions, and photodynamic therapy (PDT) is becoming increasingly important here as well. The role of the laser must be newly and more clearly defined. In certain cases it is a good alternative to PDT and to cryotherapy. Thicker and/or nodular lesions should be excised by conventional surgical methods in most cases, as histological monitoring of the margins is needed and the long-term results are better. The decision to use laser systems in the treatment of malignant tumors should be reserved for exceptional cases; it may be indicated when a lesion is inoperable. Whenever there is the slightest doubt about the benign or malignant nature of a tumor, a biopsy must be taken and examined to exclude malignancy. The occurrence of a precancerous lesion or a malignant tumor demands careful and frequent follow-up observation of the patient in all cases.

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References

  1. Alexiades-Armenakas M. Aminolevulinic acid photodynamic therapy for actinic keratoses/actinic cheilitis/acne: vascular lasers. Dermatol Clin. 2007;25(1):25–33.

    Article  CAS  PubMed  Google Scholar 

  2. Alexiades-Armenakas MR, Geronemus RG. Laser-mediated photodynamic therapy of actinic cheilitis. J Drugs Dermatol. 2004;3(5):548–51.

    PubMed  Google Scholar 

  3. Allison KP, Kiernan MN, Waters RA, et al. Pulsed dye laser treatment of superficial basal cell carcinoma: realistic or not? Lasers Med Sci. 2003;18(2):125–6.

    Article  CAS  PubMed  Google Scholar 

  4. Anderson RR. Lasers in dermatology–a critical update. J Dermatol. 2000;27(11):700–5.

    CAS  PubMed  Google Scholar 

  5. Arlette JP. Treatment of Bowen’s disease and erythroplasia of Queyrat. Br J Dermatol. 2003;149 suppl 66:43–9.

    Article  PubMed  Google Scholar 

  6. Arndt KA. Argon laser treatment of lentigo maligna. J Am Acad Dermatol. 1984;10(6):953–7.

    Article  CAS  PubMed  Google Scholar 

  7. Arndt KA. New pigmented macule appearing 4 years after argon laser treatment of lentigo maligna. J Am Acad Dermatol. 1986;14(6):1092.

    Article  CAS  PubMed  Google Scholar 

  8. Bae YC, Kang YS, Oh CK, et al. A report of 12 cases of basal cell carcinoma arising in lesions following laser therapy. Ann Plast Surg. 2005;54(4):384–6; discussion 387–9.

    Google Scholar 

  9. Becker-Wegerich PM, Fritsch C, Schulte KW, et al. Carbon dioxide laser treatment of extramammary Paget’s disease guided by photodynamic diagnosis. Br J Dermatol. 1998;138(1):169–72.

    Article  CAS  PubMed  Google Scholar 

  10. Boynton KK, Bjorkman DJ. Argon laser therapy for perianal Bowen’s disease: a case report. Lasers Surg Med. 1991;11(4):385–7.

    Article  CAS  PubMed  Google Scholar 

  11. Braun-Falco O, Plewig G, Wolff HH. Präkanzerosen. In: Braun-Falco O, Plewig G, Wolff HH, editors. Dermatologie und Venerologie. 4th edn. Berlin: Springer, 1997. p. 1311–2.

    Google Scholar 

  12. Campolmi P, Mavilia L, Bonan P, et al. 595 nm pulsed dye laser for the treatment of superficial basal cell carcinoma. Lasers Med Sci. 2005;20(3–4):147–8.

    Article  CAS  PubMed  Google Scholar 

  13. Campolmi P, Troiano M, Bonan P, et al. Vascular based non conventional dye laser treatment for basal cell carcinoma. Dermatol Ther. 2008;21(5):402–5.

    Article  CAS  PubMed  Google Scholar 

  14. Chan HH, Xiang L, Leung JC, et al. In vitro study examining the effect of sub-lethal QS 755 nm lasers on the expression of p16INK4a on melanoma cell lines. Lasers Surg Med. 2003;32(2):88–93.

    Article  PubMed  Google Scholar 

  15. Conejo-Mir JS, Muñoz MA, Linares M, et al. Carbon dioxide laser treatment of erythroplasia of Queyrat: a revisited treatment to this condition. J Eur Acad Dermatol Venereol. 2005;19(5):643–4.

    Article  CAS  PubMed  Google Scholar 

  16. Cox NH, Eedy DJ, Morton CA. Guidelines for management of Bowen’s disease: 2006 update. Therapy Guidelines and Audit Subcommittee, British Association of Dermatologists. Br J Dermatol. 2007;156(1):11–21.

    Google Scholar 

  17. Dave R, Monk B, Mahaffey P. Treatment of Bowen’s disease with carbon dioxide laser. Lasers Surg Med. 2003;32(5):335.

    Article  CAS  PubMed  Google Scholar 

  18. de Godoy Peres FF, Aigotti Haberbeck Brandão A, Rodarte Carvalho Y, et al. A study of actinic cheilitis treatment by two low-morbidity CO(2) laser vaporization one-pass protocols. Lasers Med Sci. 2008;24(3):375–85.

    Article  PubMed  Google Scholar 

  19. Del Losada JP, Ferré A, San Román B, et al. Erythroplasia of Queyrat with urethral involvement: treatment with carbon dioxide laser vaporization. Dermatol Surg. 2005;31:1454–7.

    Article  PubMed  Google Scholar 

  20. Doctoroff A, Oberlender SA, Purcell SM. Full-face carbon dioxide laser resurfacing in the management of a patient with the nevoid basal cell carcinoma syndrome. Dermatol Surg. 2003;29(12):1236–40.

    Article  PubMed  Google Scholar 

  21. Dufresne Jr RG, Curlin MU. Actinic cheilitis. A treatment review. Dermatol Surg. 1997;23(1):15–21.

    Article  PubMed  Google Scholar 

  22. El-Tonsy MH, El-Domyati MM, El-Sawy AE, et al. Continuous-wave Nd:Yag laser hyperthermia: a successful modality in treatment of basal cell carcinoma. Dermatol Online J. 2004;10(2):3.

    Google Scholar 

  23. Ericson MB, Wennberg AM, Larkö O. Review of photodynamic therapy in actinic keratosis and basal cell carcinoma. Ther Clin Risk Manag. 2008;4(1):1–9.

    CAS  PubMed  Google Scholar 

  24. Ewing TL. Paget’s disease of the vulva treated by combined surgery and laser. Gynecol Oncol. 1991;43(2):137–40.

    Article  CAS  PubMed  Google Scholar 

  25. Fitzpatrick RE, Goldman MP, Ruiz-Esparza J. Clinical advantage of the CO2 laser superpulsed mode. Treatment of verruca vulgaris, seborrheic keratoses, lentigines, and actinic cheilitis. J Dermatol Surg Oncol. 1994;20(7):449–56.

    Google Scholar 

  26. Fulton JE, Rahimi AD, Helton P, et al. Disappointing results following resurfacing of facial skin with CO2 lasers for prophylaxis of keratoses and cancers. Dermatol Surg. 1999;25(9):729–32.

    Article  CAS  PubMed  Google Scholar 

  27. Gale N, Pilch BZ, Sidransky D, et al. Epithelial precursor lesions. In: Pathology and genetics: head and neck tumours. In: Barnes L, Eveson JW, Reichart PA, Sidransky D, editors. Lyon: IARC Press, 2005. p. 140–3.

    Google Scholar 

  28. Gebert S, Raulin C, Ockenfels HM, et al. Excimer-laser (308 nm) treatment of large plaque parapsoriasis and long-term follow-up. Eur J Dermatol. 2006;16(2):198–9.

    PubMed  Google Scholar 

  29. Goldberg DJ, Stampien TM, Schwartz RA. Mycosis fungoides palmaris et plantaris: successful treatment with the carbon dioxide laser. Br J Dermatol. 1997;136(4):617–9.

    Article  CAS  PubMed  Google Scholar 

  30. Goldman L. Surgery by laser for malignant melanoma. J Dermatol Surg Oncol. 1979;5(2):141–4.

    CAS  PubMed  Google Scholar 

  31. Gooris PJ, Roodenburg JL, Vermey A, et al. Carbon dioxide laser evaporation of leukoplakia of the lower lip: a retrospective evaluation. Oral Oncol. 1999;35(5):490–5.

    Article  CAS  PubMed  Google Scholar 

  32. Greenbaum SS, Glogau R, Stegman SJ, et al. Carbon dioxide laser treatment of erythroplasia of Queyrat. J Dermatol Surg Oncol. 1989;15(7):747–50.

    CAS  PubMed  Google Scholar 

  33. Hamadah O, Thomson PJ. Factors affecting carbon dioxide laser treatment for oral precancer: a patient cohort study. Lasers Surg Med. 2009;41(1):17–25.

    Article  CAS  PubMed  Google Scholar 

  34. Hohenleutner S, Landthaler M, Hohenleutner U. CO2 laser vaporisation of actinic cheilitis. Hautarzt. 1999;50(8):562–5.

    Article  CAS  PubMed  Google Scholar 

  35. Horlock N, Grobbelaar AO, Gault DT. Can the carbon dioxide laser completely ablate basal cell carcinomas? A histological study. Br J Plast Surg. 2000;53(4):286–93.

    Article  CAS  PubMed  Google Scholar 

  36. Humphreys TR, Malhotra R, Scharf MJ, et al. Treatment of superficial basal cell carcinoma and squamous cell carcinoma in situ with a high-energy pulsed carbon dioxide laser. Arch Dermatol. 1998;134(10):1247–52.

    Article  CAS  PubMed  Google Scholar 

  37. Ishii J, Fujita K, Komori T. Laser surgery as a treatment for oral leukoplakia. Oral Oncol. 2003;39(8):759–69.

    Article  CAS  PubMed  Google Scholar 

  38. Iyer S, Bowes L, Kricorian G, et al. Treatment of basal cell carcinoma with the pulsed carbon dioxide laser: a retrospective analysis. Dermatol Surg. 2004;30(9):1214–8.

    Article  PubMed  Google Scholar 

  39. Iyer S, Friedli A, Bowes L, et al. Full face laser resurfacing: therapy and prophylaxis for actinic keratoses and non-melanoma skin cancer. Lasers Surg Med. 2004;34(2):114–9.

    Article  PubMed  Google Scholar 

  40. Iyer S, Goldman M. Treatment of lentigo maligna with combination laser therapy: recurrence at 8 months after initial resolution. J Cosmet Laser Ther. 2003;5(1):49–52.

    PubMed  Google Scholar 

  41. Jiang SB, Levine VJ, Nehal KS, et al. Er:YAG laser for the treatment of actinic keratoses. Dermatol Surg. 2000;26(5):437–40.

    Article  CAS  PubMed  Google Scholar 

  42. Johnson TM, Sebastien TS, Lowe L, et al. Carbon dioxide laser treatment of actinic cheilitis. Clinicohistopathologic correlation to determine the optimal depth of destruction. J Am Acad Dermatol. 1992;27:737–40.

    Article  CAS  PubMed  Google Scholar 

  43. Karrer S, Szeimies RM, Hohenleutner U, et al. Role of lasers and photodynamic therapy in the treatment of cutaneous malignancy. Am J Clin Dermatol. 2001;2(4):229–37.

    Article  CAS  PubMed  Google Scholar 

  44. Kopera D. Treatment of lentigo maligna with the carbon dioxide laser. Arch Dermatol. 1995;131(6):735–6.

    Article  CAS  PubMed  Google Scholar 

  45. Kroon BK, Horenblas S, Nieweg OE. Contemporary management of penile squamous cell carcinoma. J Surg Oncol. 2005;89(1):43–50.

    Article  PubMed  Google Scholar 

  46. Kunte C, Konz B. [Current recommendations in the treatment of basal cell carcinoma and squamous cell carcinoma of the skin]. Hautarzt 2007;58(5):419–26.

    Google Scholar 

  47. Landthaler M. Premalignant and malignant skin lesions. In: Achauer BM, Vander Kam VM, Berns WM, editors. Lasers in plastic surgery and dermatology. Thieme: Stuttgart, 1992. p. 34–44.

    Google Scholar 

  48. Laws RA, Wilde JL, Grabski WJ. Comparison of electrodessication with CO2 laser for the treatment of actinic cheilitis. Dermatol Surg. 2000;26(4):349–53.

    Article  CAS  PubMed  Google Scholar 

  49. Lee PK, Rosenberg CN, Tsao H, et al. Failure of Q-switched ruby laser to eradicate atypical-appearing solar lentigo: report of two cases. J Am Acad Dermatol. 1998;38:314–7.

    Article  CAS  PubMed  Google Scholar 

  50. Lodi G, Porter S. Management of potentially malignant disorders: evidence and critique. J Oral Pathol Med. 2008;37(2):63–9.

    Article  PubMed  Google Scholar 

  51. Lodi G, Sardella A, Bez C, et al. Systematic review of randomised trials for the treatment of oral leukoplakia. J Dent Educ. 2002;66:896–902.

    PubMed  Google Scholar 

  52. Lodi G, Sardella A, Bez C, et al. Interventions for treating oral leukoplakia. Cochrane Database Syst Rev. 2006;(4):CD001829.

    Google Scholar 

  53. Louis-Sylvestre C, Haddad B, Paniel BJ. Paget’s disease of the vulva: results of different conservative treatments. Eur J Obstet Gynecol Reprod Biol. 2001;99(2):253–5.

    Article  CAS  PubMed  Google Scholar 

  54. Martinez-Gonzalez MC, Pozo JD, Paradela S, et al. Bowen’s disease treated by carbon dioxide laser. A series of 44 patients. J Dermatolog Treat. 2008;11:1–4.

    Google Scholar 

  55. Mori M, Campolmi P, Mavilia L, et al. Monochromatic excimer light (308 nm) in patch-stage IA mycosis fungoides. J Am Acad Dermatol. 2004;50(6):943–5.

    Article  PubMed  Google Scholar 

  56. Niiyama N, Niiyama S, Takasu H, et al. Progression of lentigo maligna into lentigo maligna melanoma following laser treatment. Eur J Dermatol. 2007;17(3):252–3.

    PubMed  Google Scholar 

  57. Nisticó S, Costanzo A, Saraceno R, et al. Efficacy of monochromatic excimer laser radiation (308 nm) in the treatment of early stage mycosis fungoides. Br J Dermatol. 2004;151(4):877–9.

    Article  PubMed  Google Scholar 

  58. Nouri K, Chang A, Trent JT, et al. Ultrapulse CO2 used for the successful treatment of basal cell carcinomas found in patients with basal cell nevus syndrome. Dermatol Surg. 2002;28(3):287–90.

    Article  PubMed  Google Scholar 

  59. Orenstein A, Goldan O, Weissman O, et al. A new modality in the treatment of actinic cheilitis using the Er:YAG laser. J Cosmet Laser Ther. 2007;9(1):23–5.

    Article  PubMed  Google Scholar 

  60. Orenstein A, Haik J, Tamir J, Winkler E, Trau H, Malik Z, Kostenich G. Photodynamic therapy of cutaneous lymphoma using 5-aminolevulinic acid topical application. Dermatol Surg. 2000;26(8):765–9; discussion 769–70.

    Google Scholar 

  61. Orten SS, Waner M, Dinehart SM, et al. Q-switched neodymium:yttrium-aluminum-garnet laser treatment of lentigo maligna. Otolaryngol Head Neck Surg. 1999;120(3):296–302.

    Article  CAS  PubMed  Google Scholar 

  62. Ostertag JU, Quaedvlieg PJ, Neumann MH, et al. Recurrence rates and long-term follow-up after laser resurfacing as a treatment for widespread actinic keratoses on the face and scalp. Dermatol Surg. 2006;32(2):261–7.

    Article  CAS  PubMed  Google Scholar 

  63. Ostertag JU, Quaedvlieg PJ, van der Geer S, et al. A clinical comparison and long-term follow-up of topical 5-fluorouracil versus laser resurfacing in the treatment of widespread actinic keratoses. Lasers Surg Med. 2006;38(8):731–9.

    Article  PubMed  Google Scholar 

  64. Paech V, Lorenzen T, Stoehr A, et al. Remission of a cutaneous mycosis fungoides after topical 5-ALA sensitisation and photodynamic therapy in a patient with advanced HIV-infection. Eur J Med Res. 2002;7(11):477–9.

    Google Scholar 

  65. Passeron T, Angeli K, Cardot-Leccia N, et al. [Treatment of mycosis fungoides by 308 nm excimer laser: a clinical and histological study in 10 patients]. Ann Dermatol Venereol. 2007;134:225–31.

    Google Scholar 

  66. Passeron T, Zakaria W, Ostovari N, et al. Efficacy of the 308-nm excimer laser in the treatment of mycosis fungoides. Arch Dermatol. 2004;140(10):1291–3.

    Article  PubMed  Google Scholar 

  67. Puppala S. Failure of carbon dioxide laser treatment in three patients with penoscrotal extramammary Paget’s disease. BJU Int. 2001;88(9):986–7.

    Article  CAS  PubMed  Google Scholar 

  68. Raulin C, Greve B. [laser and IPL technology in dermatology and aesthetic medicine.] Stuttgart, New York: Schattauer; 2003.

    Google Scholar 

  69. Recio ED, Zambrano B, Alonso ML, et al. Topical 5-aminolevulinic acid photodynamic therapy for the treatment of unilesional mycosis fungoides: a report of two cases and review of the literature. Int J Dermatol. 2008;47(4):410–3.

    Article  CAS  PubMed  Google Scholar 

  70. Reibel J. Prognosis of oral pre-malignant lesions: significance of clinical, histopathological, and molecular biological characteristics. Crit Rev Oral Biol Med. 2003;14:47–62.

    Article  PubMed  Google Scholar 

  71. Russo GG. Actinic keratoses, basal cell carcinoma, and squamous cell carcinoma: uncommon treatments. Clin Dermatol. 2005;23(6):581–6.

    Article  PubMed  Google Scholar 

  72. Schoelch ML, Sekandari N, Regezi JA, et al. Laser management of oral leukoplakias: a follow-up study of 70 patients. Laryngoscope. 1999;109(6):949–53.

    Article  CAS  PubMed  Google Scholar 

  73. Shah SM, Konnikov N, Duncan LM, Tannous ZS. The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas. Lasers Surg Med. 2009;41(6):417–22.

    Article  PubMed  Google Scholar 

  74. Shieh S, Dee AS, Cheney RT, et al. Photodynamic therapy for the treatment of extramammary Paget’s disease. Br J Dermatol. 2003;146(6):1000–5.

    Article  Google Scholar 

  75. Siero´n A, Adamek M, Kawczyk-Krupka A, et al. Photodynamic therapy (PDT) using topically applied delta-aminolevulinic acid (ALA) for the treatment of oral leukoplakia. J Oral Pathol Med. 2003;32(6):330–6.

    Article  PubMed  Google Scholar 

  76. Stanley RJ, Roenigk RK. Actinic cheilitis: treatment with the carbon dioxide laser. Mayo Clin Proc. 1988;63(3):230–5.

    CAS  PubMed  Google Scholar 

  77. Stratigos AJ, Tahan S, Dover JS. Rapid development of nonmelanoma skin cancer after CO2 laser resurfacing. Arch Dermatol. 2002;138(5):696–7.

    Article  PubMed  Google Scholar 

  78. Strobbe LJ, Nieweg OE, Kroon BB. Carbon dioxide laser for cutaneous melanoma metastases: indications and limitations. Eur J Surg Oncol. 1997;23(5):435–8.

    Article  CAS  PubMed  Google Scholar 

  79. Szeimies RM, Morton CA, Sidoroff A, et al. Photodynamic therapy for non-melanoma skin cancer. Acta Derm Venereol. 2005;85(6):483–90.

    CAS  PubMed  Google Scholar 

  80. Thissen M, Westerhof W. Lentigo maligna treated with ruby laser. Acta Derm Venereol. 1997;77(2):163.

    CAS  PubMed  Google Scholar 

  81. Upjohn E, Foley P, Lane P, et al. Long-term clearance of patch-stage mycosis fungoides with the 308-nm laser. Clin Exp Dermatol. 2007;32(2):168–71.

    Article  CAS  PubMed  Google Scholar 

  82. Vaïsse V, Clerici T, Fusade T. [Bowen disease treated with scanned pulsed high energy CO2 laser. Follow-up of 6 cases]. Ann Dermatol Venereol. 2001;128(11):1220–4.

    Google Scholar 

  83. Valentine BH, Arena B, Green E. Laser ablation of recurrent Paget’s disease of vulva and perineum. J Gynecol Surg. 1992;8(1):21–4.

    Article  CAS  PubMed  Google Scholar 

  84. van der Hem PS, Nauta JM, van der Wal JE, et al. The results of CO2 laser surgery in patients with oral leukoplakia: a 25 year follow up. Oral Oncol. 2005;41(1):31–7.

    Article  PubMed  Google Scholar 

  85. Vivek V, Jayasree RS, Balan A, et al. Three-year follow-up of oral leukoplakia after neodymium:yttrium aluminum garnet (Nd:YAG) laser surgery. Lasers Med Sci. 2008;23:375–9.

    Google Scholar 

  86. Wang KH, Fang JY, Hu CH, et al. Erbium:YAG laser pretreatment accelerates the response of Bowen’s disease treated by topical 5-fluorouracil. Dermatol Surg. 2004;30(3):441–5.

    Article  PubMed  Google Scholar 

  87. Weese D, Murphy J, Zimmern PE. Nd: YAG laser treatment of extramammary Paget’s disease of the penis and scrotum. J Urol (Paris). 1993;99(5):269–71.

    CAS  Google Scholar 

  88. Whitaker DC. Microscopically proven cure of actinic cheilitis by CO2 laser. Lasers Surg Med. 1987;7(6):520–3.

    Article  CAS  PubMed  Google Scholar 

  89. White JM, Chaudhry SI, Kudler JJ, et al. Nd:YAG and CO2 laser therapy of oral mucosal lesions. J Clin Laser Med Surg. 1998;16(6):299–304.

    CAS  PubMed  Google Scholar 

  90. Zeitouni NC, Shieh S, Oseroff AR. Laser and photodynamic therapy in the management of cutaneous malignancies. Clin Dermatol. 2001;19(3):328–38.

    Article  CAS  PubMed  Google Scholar 

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  1. Laserklinik Karlsruhe, Kaiserstraße 104, 76133, Karlsruhe, Germany

    Christian Raulin, Syrus Karsai & Laurenz Schmitt

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    Christian Raulin

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    Syrus Karsai

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Raulin, C., Karsai, S., Schmitt, L. (2011). Precancerous Conditions and Malignant Tumors. In: Raulin, C., Karsai, S. (eds) Laser and IPL Technology in Dermatology and Aesthetic Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03438-1_12

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